<div class="pageContent">
	
	<form method="post" action="/index.php?act=represent&st=representAdd" class="pageForm required-validate" onsubmit="return validateCallback(this, dialogAjaxDone)">
		<div class="pageFormContent" layoutH="58">

			<p>
				<label>用户ID：</label>
				<input name="User_ID" type="text" size="30" value="" class="required" errormsg="请输入用户ID"/>
			</p>
			<p>
				<label>提出单位：</label>
				<input name="User_Company" type="text" size="30" value="" class="required" errormsg="请输入提出单位"/>
			</p>
			<p>
				<label>提出人姓名：</label>
				<input name="User_Person" type="text" size="30" value="" class="required" errormsg="请输入提出人姓名"/>
			</p>
			<p>
				<label>产品名称：</label>
				<input name="Product_Type" type="text" size="30" value="" class="required" errormsg="请输入产品名称"/>
			</p>
			<div class="divider"></div>
			<p>
				<label>产品规格：</label>
				<input name="Product_Spec" type="text" size="30" value="" class="required" errormsg="请输入产品规格"/>
			</p>
			<p>
				<label>材质牌号：</label>
				<input name="Product_Grade" type="text" size="30" value="" class="required" errormsg="请输入材质牌号" />
			</p>
			<p>
				<label>合同号或炉批号：</label>
				<input name="Problem_Batch" class="required" type="text" size="30" value="" errormsg="请输入合同号或炉批号"/>
			</p>
			<p>
				<label>异议成品：</label>
				<input name="Qty_Product" class="number required" type="text" size="30" value="" errormsg="请输入异议成品"/>
			</p>
			<p>
				<label>异议半成品：</label>
				<input name="Qty_Product_Semi" class="number required" type="text" size="30" value="" errormsg="请输入异议半成品"/>
			</p>
			<p>
				<label>异议母材：</label>
				<input name="Qty_Product_Parent" class="number required" type="text" size="30" value="" errormsg="请输入异议母材"/>
			</p>
			<div class="divider"></div>
			<p>
				<label>缺陷问题类型：</label>
				<input name="Defect_Type" class="required" type="text" size="30" value="" errormsg="请输入缺陷问题类型"/>
			</p>
			<p>
				<label>缺陷问题特征简述：</label>
				<input name="Defect_Description" class="required" type="text" size="30" value="" errormsg="请输入缺陷问题特征简述"/>
			</p>
			<p>
				<label>使用影响及挽救措施：</label>
				<input name="Loss_Description" class="required" type="text" size="30" value="" errormsg="请输入对使用的影响及挽救措施"/>
			</p>
			<p>
				<label>造成的直接经济损失：</label>
				<input name="Loss_Money" class="number required" type="text" size="30" value="" errormsg="请输入造成的直接经济损失"/>
			</p>
			<p>
				<label>损失构成及测算方式：</label>
				<input name="Loss_Calculate" class="required" type="text" size="30" value="" errormsg="请输入损失构成及测算方式"/>
			</p>

			<p>
				<label>异议确认地点：</label>
				<input name="Confirm_Addr" class="required" type="text" size="30" value="" errormsg="请输入异议确认地点"/>
			</p>
			<p>
				<label>确认时联系人：</label>
				<input name="Confirm_Person" class="required" type="text" size="30" value="" errormsg="请输入确认时联系人"/>
			</p>
			<p>
				<label>联系人手机号：</label>
				<input name="Confirm_Mobile" class="required" type="text" size="30" value="" errormsg="请输入联系人手机号"/>
			</p>
		</div>

		<div class="formBar">
			<ul>
				<li><div class="buttonActive"><div class="buttonContent"><button type="submit">提交</button></div></div></li>
				<li><div class="button"><div class="buttonContent"><button type="button" class="close">取消</button></div></div></li>
			</ul>
		</div>

	</form>

</div>

